CONSENT TO USE BUSINESS NAME SECRETARY OF STATE

CONSENT TO USE BUSINESS name SECRETARY OF STATE SFN 59250 (05-2016)For Office Use OnlyID Number:WO Number:Filed:By:FILING FEE: $ name of the BUSINESS or organization currently registered with the North Dakota SECRETARY of STATE that is granting CONSENT to use a BUSINESS name that is the same or is deceptively similar 2. Proposed BUSINESS name for which CONSENT is being granted3. "I (We), the owner(s), or the person(s) authorized to sign on behalf of the BUSINESS named in number 1, hereby grant CONSENT to the BUSINESS name defined in number 2 and accept responsibility to monitor or enforce any restrictions or limitations agreed to by the BUSINESS named in number 2. I (We) understand that if I (we) make a false statement in this document, I (we) may be subject to criminal penalties.

to the business name defined in number 2 and accept responsibility to monitor or enforce any restrictions or limitations agreed to by the business named in number 2. I (We) understand that if I (we) make a false statement in this document, I (we) may be subject to criminal penalties." Signature Title Date Signature Title Date 4.

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